Leading medical organizations, including the American Medical Association, are strongly appealing to the Trump administration to waive the hefty new H-1B visa fees for international physicians. They argue that these significant costs will worsen the already critical doctor shortage, negatively impact patient care, and ultimately increase healthcare expenses across the nation.
Foreign-trained doctors represent almost a quarter of the medical workforce in the U.S. They are crucial for staffing hospitals and clinics in rural and underserved communities, often taking on roles in vital, yet less popular, specialties such as primary care, psychiatry, and pediatrics—areas where American-trained physicians are less likely to practice.
A large number of these international medical professionals hold H-1B visas, which are designated for skilled workers in specialized fields. Just this week, President Trump unveiled a plan to impose a staggering $100,000 fee for each new H-1B visa.
Dr. Bobby Mukkamala, president of the American Medical Association, voiced grave concerns: “If a hospital requires 50 foreign residents, and each visa costs $100,000, that amounts to $5 million. This simply isn’t feasible, and it will inevitably lead to severe staff shortages.”
He further explained that this cost, which employers must cover, would be an immense burden on hospitals and healthcare systems. Many of these institutions are non-profits, and those in rural areas are already struggling, often cutting services or even shutting down completely.
Dr. Mukkamala warned that without exemptions for international doctors vital to American patient care, hospital positions would remain vacant. This would result in longer wait times for patients and increased strain on emergency departments.
Notably, Dr. Mukkamala, an ENT surgeon practicing in Flint, Michigan, is the son of physicians who themselves immigrated from India in the 1970s.
The U.S. already faces a projected shortfall of up to 86,000 doctors by 2036, according to the A.M.A. This deficit is expected to grow as the population ages and the prevalence of chronic and behavioral health conditions increases, demanding even greater healthcare resources.
Beyond doctors, these new visa fees could also worsen the ongoing nursing shortage. The healthcare sector heavily relies on foreign-educated registered nurses; in 2022, approximately half a million immigrant nurses were working in the U.S., making up one in six of the country’s over three million registered nurses.
These additional visa expenses compound the financial pressures on hospitals, which are already bracing for a surge in uninsured patients due to recent cuts in health insurance subsidies and reduced Medicaid reimbursements.
In a formal letter addressed to Kristi Noem, the Secretary of Homeland Security, the A.M.A. and various other medical groups have formally requested that the new H-1B visa fees for physicians be rescinded.
The executive order implementing these fees includes a clause specifying that they should not apply to foreign ‘specialty occupation workers’ whose employment is deemed ‘in the national interest and does not pose a threat to the security or welfare of the United States.’
President Trump instituted the $100,000 fees on September 21st, asserting they are essential to safeguard American jobs, prevent exploitation, and guarantee that only highly skilled and highly compensated foreign professionals receive these visas. It’s important to note that these new fees do not impact current H-1B visa holders.
While the White House and the Department of Homeland Security did not immediately comment, White House spokesman Taylor Rogers told Bloomberg News this week that the proclamation “allows for potential exemptions, which can include physicians and medical residents.”
This recent development is not an isolated incident; visa restrictions have repeatedly posed a threat to hospital staffing across the nation in recent months.
For instance, in late May, President Trump halted new interview appointments for J-1 visas. These visas are vital for recent international medical graduates to serve as residents and interns in the U.S., roles known for demanding 80-hour workweeks and modest salaries. Hospitals depend heavily on these residents to maintain adequate staffing levels.
International doctors comprise a significant portion—one in six—of medical residents and specialized fellows at U.S. teaching hospitals. In 2024 alone, the Educational Commission for Foreign Medical Graduates facilitated visas for over 15,500 physicians from more than 150 countries to undertake residency or fellowship training at 770 hospitals.
Despite efforts by some hospitals to expand training programs and cultivate more domestic healthcare professionals, Colin Milligan, a spokesman for the American Hospital Association, emphasized that “one of the short-term strategies used by U.S. hospitals to address personnel shortages is the use of foreign-trained health care workers.”
The American Hospital Association stated its commitment to working with the administration, highlighting the critical need to include healthcare personnel in any potential exemptions to these new visa regulations.
Dr. Mukkamala reflected on his own family’s history, noting that when his parents immigrated to the U.S., “it was an open door, because the country needed physicians.”
He starkly concluded, “Now it’s not an open door. It’s a closed door, and you’ve got to pay $100,000 to open it.”